This song is playing and re-playing in my head in light of the SMF topic today: the importance of talking with one’s intimate partner when painful sex is part of the scene. Maybe it’s new onset after having been somewhere between “sex was OK” and “sex used to be mind-blowing”; or maybe it’s been painful from the very first time. Regardless, it is always indicative of something going on. In clinical practice we see A LOT of physical reasons (tight muscles, irritated nerves, sensitive skin tissue), but there is no understating the way that this can get in your head. And as much as finding health care providers to help through the mental and physical factors is important, how partners handle this in relationship to each other is equally important.

Caryn Phillips, pelvic health and obstetric physical therapist at Marathon Physical Therapy, shares more about this important topic.

To all the partners out there, sing along,

Jessica

Want Pain-Free Sex?? Then TALK about it!!

“I deal with the pain because I feel bad for my husband”

“My boyfriend gets frustrated that we can’t have sex, and it makes me feel guilty”

The quotes above (or some variation) are words I hear all too often. Although I have had the occasional close friend or family member voice similar concerns to me, I most often hear it from patients of mine. That is because I am a pelvic floor physical therapist that treats women who have pain during intercourse.

You may be thinking “well, if I were having pain with sex, I’d probably think the same things”. You may be having painful sex right now, and are planning to continue to do so. Well I want you to know that painful sex is NOT normal and continuing to engage in painful sex for the sake of your partner can lead to even more pain and possible worsening of your sexual and pelvic health.

We’ve said before – and will continue to do so – that treatment is available for those experiencing painful sex. But what happens when you leave the PT clinic, the doctor’s office, or any other “treatment” and go to the bedroom? Not much will be successful if one very important thing is missing from the equation…support from your partner and a relationship with good communication.

When a relationship is lacking good communication and support from the partner, it negatively impacts the emotional well being of the person experiencing the problem. It can lead to feelings including guilt, anxiety, shame, sadness and frustration. All of these feeling will increase one’s stress levels, which can lead to…more tightness in the pelvic floor!!

How does that work?

When a person is experiencing stress, it can manifest as tension in the body, which can include the pelvic floor muscles. Stress can come from many things: work, fatigue, nervousness, relationships, etc. Many women who have experienced painful sex admit to having some level of anxiety prior to engaging in sexual activity with their partner. This anxiety before sex can cause increased tightness in the pelvic floor resulting in pain with initial penetration. Unfortunately, I have had many women tell me that they do not voice this anxiety to their partners, and just “deal with it”. This is NOT what you want to be doing. You have to be able to talk about the pain with your partner, or else he/she will not know how to help you. A big part of pelvic floor PT is educating the patient and her partner about ways to relax in the bedroom, and communication must be present for the techniques to actually work!

Then there is the small chance that a woman may have an unsupportive partner (which I have unfortunately seen before). This can be a huge barrier to relaxing your muscles and ultimately engaging in pain-free sex. Your partner should NOT be pressuring you, making you feel bad, or punishing you in ANY way for the fact that sex is painful for you. If you feel that this is the case, the first step may be speaking to a therapist or other professional about how to build a stronger, more supportive relationship. Without this healthy, positive base consisting of support and communication, the effects pelvic floor PT can have may be limited.

Please make sure you are communicating with your partner and make sure you feel COMFORTABLE communicating with them. If you don’t feel comfortable, seek help from a professional and encourage your partner to do so. No one should settle for painful sex, you deserve better!